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{{Short description|Culture-bound medical condition}}
{{Infobox medical condition (new)
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| field = [[Psychiatry]]
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'''Dhat syndrome''' ([[Sanskrit]]: धातु दोष, [[IAST]]: Dhātu doṣa) is a condition found in the cultures of [[South Asia]] (including Pakistan, India, Bangladesh, Nepal, and Sri Lanka) in which male patients report that they suffer from [[premature ejaculation]] or [[impotence]], and believe that they are [[spermaturia|passing semen in their urine]].<ref>{{cite journal |title=The Concept and Epidemiology of Dhat Syndrome |journal=Journal of Pakistan Psychiatric Society |date=2005 |volume=2 |issue=1 |url=http://www.jpps.com.pk/article/theconceptandepidemiologyofdhatsyndrome_2231.html|author=Ajit Avasthi, Om Prakash Jhirwal}}</ref> The condition has no known organic cause.<ref name=reappraisal>{{cite journal |doi=10.4103/0019-5154.49002|title=Dhat syndrome :A reappraisal|journal=Indian Journal of Dermatology|volume=54|pages=89–90|year=2009|last1=Mehta|first1=Vandana|last2=De|first2=Abhishek|last3=Balachandran|first3=C.|issue=1|pmid=20049284|pmc=2800886 |doi-access=free }}</ref>

In traditional [[Hinduism|Hindu]] spirituality, semen is described as a "vital fluid". The discharge of this "vital fluid", either through [[sex]] or [[masturbation]], is associated with marked feelings of [[anxiety]] and [[dysphoria]]. Often the patient describes the loss of a whitish fluid while passing urine. At other times, marked feelings of guilt associated with what the patient assumes is "excessive" masturbation are noted.

Many doctors view dhat as a folk diagnostic term used in South Asia to refer to anxiety and hypochondriacal concerns associated with the discharge of semen, with discoloration of the urine, and feelings of weakness and exhaustion.

Dhat is thought to be a [[culture-bound syndrome]] similar to ''jiryan'' ([[South-East Asia]]), ''prameha'' ([[Sri Lanka]]), and
''[[shenkui]]'' ([[China]]).<ref>American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (DSM-IV-TR) (4th ed., text revision). Washington, D.C.: American Psychiatric Association. Pages 897-903.</ref> Dhat syndrome might be related to other post-orgasmic diseases, such as [[post-coital tristesse]] (PCT), [[postorgasmic illness syndrome]] (POIS), and [[sexual headache]].

==Signs and symptoms==
Young males are most often affected, though similar symptoms have been reported in females with excessive vaginal discharge or [[leucorrhea]], which is also considered a "vital fluid". In addition, there are symptoms of fatigue and weakness.<ref>{{Cite journal |last1=Mehta |first1=Vandana |last2=De |first2=Abhishek |last3=Balachandran |first3=C |title=Dhat syndrome :A reappraisal |date=2009 |journal=Indian Journal of Dermatology |volume=54 |issue=1 |pages=89–90 |doi=10.4103/0019-5154.49002 |issn=0019-5154 |pmc=2800886 |pmid=20049284 |doi-access=free }}</ref> Patients with Dhat condition most normally ascribe their semen misfortune (secretion of semen in urine) to reasons like inordinate masturbation, sensual dreams, and unreasonable sexual longing. Nocturnal emission and secretion of semen in urine are considered to be the most widely recognized symptoms of semen misfortune. Patients with Dhat condition frequently dread the result of semen misfortune and regularly have the conviction that it will lead to decrease in sexual performance. The most widely recognized side effects in patients with Dhat condition are shortcoming of the body, sluggishness, low energy, and low temperament.<ref>{{Cite journal |last1=Prakash |first1=Om |last2=Kar |first2=Sujita Kumar |date=July 2019 |title=Dhat Syndrome: A Review and Update |journal=Journal of Psychosexual Health |language=en |volume=1 |issue=3–4 |pages=241–245 |doi=10.1177/2631831819894769 |s2cid=209522985 |issn=2631-8318|doi-access=free }}</ref> Premature ejaculation and impotence are commonly seen. Other somatic symptoms like weakness, easy fatiguability, palpitations, insomnia, low mood, guilt and anxiety are often present. Males sometimes report a subjective feeling that their penises have shortened. These symptoms are usually associated with an anxious and dysphoric mood state.<ref>A., Avasthir., O. P., Jhirwai. (2005). "The concept and epidemiology of dhat syndrome".''The Journal of Pakistan Psychiatric Society''.''2''(6). [http://www.jpps.com.pk/article/theconceptandepidemiologyofdhatsyndrome_2231.html]</ref> Another sign of this syndrome is white discharge.<ref>{{Cite journal |last1=Grover |first1=Sandeep |last2=Kate |first2=Natasha |last3=Avasthi |first3=Ajit |last4=Rajpal |first4=Nikita |last5=Umamaheswari |first5=V. |date=2014 |title=Females too suffer from Dhat syndrome: A case series and revisit of the concept |journal=Indian Journal of Psychiatry |volume=56 |issue=4 |pages=388–392 |doi=10.4103/0019-5545.146537 |issn=0019-5545 |pmc=4279300 |pmid=25568483 |doi-access=free }}</ref> According to Ayurveda, an Indian medical system, men who have experienced this have shown signs of anxiety issues.<ref>{{Cite journal |last1=Grover |first1=Sandeep |last2=Avasthi |first2=Ajit |last3=Gupta |first3=Sunil |last4=Hazari |first4=Nandita |last5=Malhotra |first5=Nidhi |date=2016 |title=Do female patients with nonpathological vaginal discharge need the same evaluation as for Dhat syndrome in males? |journal=Indian Journal of Psychiatry |volume=58 |issue=1 |pages=61–69 |doi=10.4103/0019-5545.174376 |issn=0019-5545 |pmc=4776585 |pmid=26985107 |doi-access=free }}</ref> This disease is a culture bound syndrome. Semen loss is generally viewed as taboo and harmful.<ref name="Malhotra 519–528">{{Cite journal |last1=Malhotra |first1=H. K. |last2=Wig |first2=N. N. |date=1975-09-01 |title=Dhat syndrome: A culture-bound sex neurosis of the orient |url=https://doi.org/10.1007/BF01542130 |journal=Archives of Sexual Behavior |language=en |volume=4 |issue=5 |pages=519–528 |doi=10.1007/BF01542130 |pmid=1191004 |s2cid=31611632 |issn=1573-2800|url-access=subscription }}</ref> It is also associated with a lower socioeconomic class. Being able to produce semen is viewed as longevity of one's health and certain powers.<ref name="Malhotra 519–528"/> In Indian culture, it is important for a man to produce semen.

==Treatment==
[[Cognitive behavioral therapy]] is the mainstay of treatment. At other times counseling, anti-anxiety and antidepressant medications have been shown to be of use.<ref>Ruterbusch, K. (2012, July 20) "Dhat Syndrome in the Indian Subcontinent", Retrieved March 29, 2013, from anthropology.msu.edu.[http://anthropology.msu.edu/anp204-us12/2012/07/20/dhat-syndrome-in-the-indian-subcontinent/] {{Webarchive|url=https://web.archive.org/web/20150407042145/http://anthropology.msu.edu/anp204-us12/2012/07/20/dhat-syndrome-in-the-indian-subcontinent/|date=2015-04-07}}</ref> Doctors have found that antidepressant medicines have shown positive results in controlling the Dhat syndrome's psychological causes."<ref>Ohman, [https://www.ohman.in/dhat-syndrome/ Dhat Syndrome Treatment]</ref>

==Epidemiology==
Dhat syndrome has been reported throughout South Asia in several communities."<ref name="Khan2005">{{cite journal |last1=Khan |first1=Nashi |title=Dhat syndrome in relation to demographic characteristics |journal=Indian Journal of Psychiatry |date=2005 |volume=47 |issue=1 |pages=105–10 |doi=10.4103/0019-5545.46077 |pmc=2918320 |doi-access=free }}</ref>

==History==
Both in Asian and Western contexts, [[Ethnomedicine|ethnomedical]] concerns for physical ailments tied to semen loss were gradually joined and moderated by [[Cross-cultural psychiatry|ethnopsychiatric]] notions of semen loss anxiety. European proto-psychiatric interests in anxiety tied to [[spermatorrhea]] go back to the eighteenth century.<ref>{{Cite journal |last=Janssen |first=Diederik F. |date=2024-12-01 |title=Dhat Syndrome East and West: A History in Two Acts |url=https://link.springer.com/article/10.1007/s11013-024-09874-4 |journal=Culture, Medicine, and Psychiatry |language=en |volume=48 |issue=4 |pages=918–939 |doi=10.1007/s11013-024-09874-4 |pmid=39136849 |issn=1573-076X|url-access=subscription }}</ref>

The term ''Dhat'' gets its origin from the [[Sanskrit]] word ''Dhatu'' (धातु), which, according to the [[Sushruta Samhita]], means "elixir that constitutes the body". Indian doctor [[N. N. Wig]] coined the term Dhat syndrome in 1960,<ref>{{Cite web |date=2019-09-02 |title=Why India has a bad case of Dhat syndrome |url=https://www.firstpost.com/health/why-india-has-a-bad-case-of-dhat-syndrome-7255831.html |access-date=2024-02-09 |website=Firstpost |language=en}}</ref> and described it as being characterized by vague [[psychosomatic]] symptoms of fatigue, weakness, anxiety, loss of appetite, guilt, and sexual dysfunction, attributed by the patient to loss of semen in [[nocturnal emission]], through urine or masturbation.<ref>Narendra Wig, "Problems of Mental Health in India", ''Clinical Society Journal (Lucknow)'', 1960; 17: 48–53.</ref> Literature describing semen as a vital constituent of the human body dates back to 1500 BC. The disorders of ''Dhatus'' have been elucidated in the [[Charaka Samhita]], which describes a disorder called ''Shukrameha'' (शुक्रमेह) in which there is a [[spermaturia|passage of semen in the urine]]. In China, various names such as ([[Shen K'uei]]), Sri Lanka ([[Prameha]]) and other parts of South East Asia ([[Jiryan]]) symptoms and conditions are similar to ''dhatus''.<ref name="reappraisal" /> The International Classification of diseases ICD-10 classifies Dhat syndrome as both a neurotic disorder (code F48.8) and a culture-specific disorder (Annexe 2) caused by "undue concern about the debilitating effects of the passage of semen".<ref>{{Cite journal |doi = 10.1111/j.1708-8305.2008.00264.x|pmid = 19192133|title = Forty Meals for a Drop of Blood …|journal = Journal of Travel Medicine|volume = 16|pages = 64–65|year = 2009|last1 = El Hamad|first1 = Issa|last2 = Scarcella|first2 = Carmelo|last3 = Pezzoli|first3 = Maria Chiara|last4 = Bergamaschi|first4 = Viviana|last5 = Castelli|first5 = Francesco|issue = 1|doi-access = free}}</ref>

==Society and culture==
Some doctors believe Dhat syndrome to be either a culture-bound presentation of [[clinical depression]], as a [[somatization|somatized]] set of symptoms, or a result of Western doctors' misinterpretation of patients' descriptions of their condition.<ref name="Sumathipala">{{cite journal |vauthors=Sumathipala A, Siribaddana SH, Bhugra D |title=Culture-bound syndromes: the story of dhat syndrome |journal=Br J Psychiatry |volume=184 |issue= 3|pages=200–9 |date=March 2004 |pmid=14990517 |doi= 10.1192/bjp.184.3.200 |doi-access=free }}</ref><ref>{{cite journal |vauthors=Dhikav V, Aggarwal N, Gupta S, Jadhavi R, Singh K |title=Depression in Dhat syndrome |journal=[[J Sex Med]] |volume=5 |issue=4 |pages=841–4 |year=2008 |pmid=17451483 |doi=10.1111/j.1743-6109.2007.00481.x}}</ref>

Dhat syndrome is very common in Nepali culture as well. Most of them come with the complaints of "drops" and become extremely anxious about it and see it as loss of "male power". It is often related with obsessive ruminations and [[somatoform]] symptoms. According to Sumathipala et al., it is likely a distinct clinical entity which is less culture-bound than these critics assert. They describe it as one form of a syndrome of "[[semen-loss anxiety]]" which also occurs in other Eastern cultures as [[jiryan]] and [[shen-k'uei]], as well as in Western cultures.<ref name="Sumathipala"/>

[[Chlamydia infection]] might also be related to it because of similar symptoms in case of infection of the [[urethra]] ([[urethritis]]), which is usually symptomatic, causing a white discharge from the penis with or without pain on urinating ([[dysuria]]).{{citation needed|date=April 2024}}

==See also==
*[[Cross-cultural psychiatry]]
*[[Koro (medicine)|Koro]]
*[[Shenkui]]

==References==
{{reflist}}

==External links==
*

{{Medicine}}
{{Post-orgasmic diseases}}
{{Medical resources
| ICD10={{ICD10|F|48|8|f|40}}
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{{Authority control}}

{{DEFAULTSORT:Dhat Syndrome}}
[[Category:Stress-related disorders]]
[[Category:Culture-bound syndromes]]
[[Category:Sexual health]]

Dhat syndrome - Revision history

Venu ji yes: Adding Basic Post Added Tags